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Can Someone Knowledgable Interpret These MRI Results?

Lucky64
Posts: 29
Joined: Jun 2017

Hello,

 

On Wednesday I had surgery but on Monday I had a MRI and just got the results. It's all Greek to me! If someone can distill it down to layman's terms I'd greatly appreciate it. The surgeon, who has done 4000 RPs said it all went well and he felt a firmness on the left side of the prostate. Path lab results come next week. Here is what I was sent:

MRI PROSTATE WWO; 7/17/2017 4:02 PM

CLINICAL INFORMATION: Male 63 years old Reason: staging History: clinical trial exam,

prostate biopsy 5/9/2017

TECHNIQUE: Multiplanar, multisequence MRI of the prostate. Pre and post contrast sequences

were obtained following intravenous administration of 17mL Multihance (Per Tech Bruce via

phone); 

COMPARISON: None

FINDINGS:

PELVIS:

PROSTATE:

Prostate Size: 5.2 x 4.1 x 4.7 cm.

Peripheral Zone: Heterogeneous. Low T2 signal lesion with areas of restricted diffusion

in the left mid gland to apex peripheral zone measures at least 7 mm

Central Gland: T2 hyperintense lesion in the lower anterior gland which appears globular

and has some areas of low ADC measures 10 mm

Multiple nodules in the central gland with areas of restricted diffusion heterogeneity

likely representing BPH nodules. This causes asymmetric hypertrophy of the left central

gland distortion of the gland architecture.

Seminal Vesicles: Seminal vessels are not distended.

Extracapsular Extension: No definite

BLADDER: No significant abnormality noted.

LYMPH NODES: No pelvic lymphadenopathy.

BONES, SOFT TISSUES: No significant abnormality noted.

OTHER: No significant abnormality noted.

IMPRESSION: 

1. Left peripheral zone 7 mm lesion - PIRADS 5

2. Apical anterior lesion - PIRADS 4

PI-RADS v2 Assessment Categories:

PIRADS 1 - Very low (clinically significant cancer is highly unlikely to be present) 

PIRADS 2 - Low (clinically significant cancer is unlikely to be present)

PIRADS 3 - Intermediate (the presence of clinically significant cancer is equivocal)

PIRADS 4 - High (clinically significant cancer is likely to be present) 

PIRADS 5 - Very high (clinically significant cancer is highly likely to be present)

https://www.acr.org/~/media/ACR/Documents/PDF/QualitySafety/Resources/PIRADS/PIRADS%20V2

pdf

 

Report Electronically Signed: 7/18/2017 10:25 AM 

[b]

Old Salt
Posts: 720
Joined: Aug 2014

I am by no means a radiologist, but it appears that you had two suspicious areas. See IMPRESSION in the above report.

The pathology report should be (much) more informative.

VascodaGama's picture
VascodaGama
Posts: 2988
Joined: Nov 2010

I agree with Old Salt, the pathologist report will give the important details of what existed in the prostate. The MRI only indicates on suspicious tumors in two areas. Let's hope for the best.

Best wishes for full recovery.

VG

GeorgeG
Posts: 127
Joined: May 2017

Agree with OS and VG. Imaging for PCA has been a challenge in the past and only starting to become useful for diagnosis and so far only in a general sense using an MRI. If done with 3 Tesla multiparametric dynamic contrast then these newer images can give a better indication of what is going on but the pathology and or rigorous biopsy gives additional required information for a full diagnosis. By example even if MRI shows lesions with good certainty you don't know anything about the Gleason score (agressiveness) of the cells and that means everything to a PCA patient.

For you it would appear that something may be going on that required further action. For me the most advanced MRI was correct in assuming advanced PCA outside the capsule but was wrong about any lymph node involvement and did not know anything about the Gleason score. It can be nerve racking during the process if things look suspicious but you don't have the entire picture yet so try to stay positive and as relaxed as possible. Please use your energy to get educated and seek out the best possible doctors and facilities available to you because the skill and art of the doctors is very important. The best doctors and facilites are saving lives every day and have the best knowledge and advice. They are not all created equally and on each major step you only get one shot so you want to make it a good one. .  Good luck and keep us posted.

 

George 

Lucky64
Posts: 29
Joined: Jun 2017

Thanks guys!

 

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